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A new patient capacity process is being adopted at New Waterford Consolidated Hospital’s emergency department (ED)/collaborative emergency centre (CEC) this month.

The process is being put in place to better manage the flow of patients through the ED/CEC and to provide support to physicians working in the department prior to closures.

“We’re putting a patient capacity process in place that supports both a patient safety and work-life balance,” says Barb O’Neill, director, emergency program of care with Nova Scotia Health Authority’s (NSHA) Eastern Zone. “We have very dedicated doctors and staff so it’s not unusual for them to still be seeing patients long after their shift is done. Working longer than expected hours is hard on anyone, whether they are doctors, nurses, truck drivers, pilots etc. People can become overwhelmed and too tired to work safely. For us, patient safety is our priority. If our doctors and nurses are working well past their shifts to see patients then that makes it difficult for them to do their work safely and efficiently.”

Starting Tuesday, Dec. 18, the ED/CEC will be open to the public from 7 a.m. to 4 p.m. Tuesday to Saturday. Patient triage and registration will stop at 4 p.m.

Patient capacity occurs when a unit or department reaches the maximum number of patients it can safely treat. A combination of the number of patients and how sick they are leads to patient capacity. A similar process was put in place at Northside General Hospital in December 2017 and at the Glace Bay Hospital in May 2018.

“Normally, patient capacity doesn’t happen all at once” says O’Neill. “There’s a natural ebb and flow to any ED/CEC. Staff are well-trained and are able to recognize any situations or volumes that are ramping up. Then they are able to put measures in place to help deal with the patient volume and workload.”

Under the new process, doctors and nursing staff will assess the workload and patient flow in the ED/CEC throughout the day. This will help determine if all registered patients can be seen and assessed by a doctor before the ED/CEC closes.

If patient capacity is reached, people who are registered and waiting may not necessarily be seen that day. This will also depend on the seriousness of the patient’s health issue.

Under patient capacity, the priority is to see people who have been triaged with an emergency or urgent health issue. Registered patients triaged with less urgent or non-urgent health issues may or may not be seen by a doctor, depending on patient flow.

People triaged and registered with less urgent or non-urgent health issues after patient capacity is reached will most likely not see a doctor. An ED/CEC team member will give all people triaged with less urgent or non-urgent health issues other treatment options. Those options include coming back to the ED/CEC the next day, going to the nearest open ED or seeing their family doctor.

These changes were developed with clinical leaders, nursing staff and the doctors who provide coverage at the New Waterford ED/CEC.